Archive for June, 2012

posted by Amy on Jun 12

Yesterday at my metastatic breast cancer support group I said I have gotten to a place of acceptance about my cancer that allows me to keep it in the background most of the time. The facilitator asked me how I had managed to do that, and I said I didn’t know. Another member had a wonderful insight, though. She noted that both I and another woman who had expressed a similar sentiment had been through setbacks and had come out on the other side. Although my setback was quite minor compared to the other woman’s, it’s still true that we have both hit bumps in our road but are feeling better now, both physically and emotionally. In this and many other ways the support group is indispensable for helping reach acceptance and gratitude in the face of constantly-evolving circumstances. The same woman also pointed out once that at our age a certain level of disability and pain is par for the course, even for people who don’t have cancer. I don’t know what I’d do without this group.

I had a PET scan on May 15 that showed a little bit of cancer progression. Unlike the “almost perfect” PET from December 5, there were a few small areas that “lit up” in the presence of the radioactive glucose, including five areas that had not shown any avidity before. That threw me for a loop. I was sad, disappointed, scared and disillusioned at this news. I had been hoping against hope for a cure. No such luck, or at least not yet. That was a tough pill to swallow.

Of course then the next question is what to do. My oncologist was hoping I could get into a trial of one of the exciting new treatments that are coming online (see below), but I didn’t qualify. I ended up agreeing to participate in a study of a drug combination that is approved for some other, slightly different, circumstances than mine but has not yet been cleared as a second-line treatment. Both drugs are biologic, targeted therapies, not chemo. I’m already on one of them. Both drugs are approved, and the doses are agreed upon. I started the new regimen yesterday.

But in the meantime I reached an important realization. The level of cancer in my body is still quite low. It doesn’t get in my way at all. It doesn’t affect me physically. I have the same capabilities, the same energy level, the same sense of physical wellbeing I had before I knew I had cancer. If it never got worse than it is right now I would be fine. If it could be kept stable it would not be a problem. The inconvenience and side effects of my current treatment are well worth it. Right now, for me, cancer is a chronic condition with minimal consequences. I realize that “if it never got worse than it is right now” is a very big “if.” For now it’s enough for me.

This new drug combination (Lapitinib and Trastuzumab) could prove to be a “home run” for me. Even if doesn’t clear the cancer completely, I can live with it just keeping me stable.

To enter the drug study I had to have a biopsy, mammogram, sonogram, CT scan, echocardiogram, EKG, and blood tests. I also had to quit taking the hormonal treatment. The CT scan is dated three weeks after the PET that had showed progression. According to the CT, there was no adverse change since the PET. Three lymph nodes that “lit up” are so small they would not have been considered abnormal if not for the PET evidence. I’m happy about that. And I think it’s still possible that the puzzle of how to train my immune system to put this thing to sleep completely can be solved at some point. So far, even though I have an aggressive and deadly type of breast cancer, it is relatively well behaved for me.

Life can only be lived in the here and now. It is vain to live in regret or in fear. Right now I’m fine. Right now I can do what I need to do. And I hope and pray that whatever may come, I will continue to have the strength to meet it head on.

Here’s a short interview about TDM-1, a drug that uses Trastuzumab (Herceptin) to find cancer cells and then deliver a cytotoxin directly to them:

Dr. Kimberly Blackwell discusses TDM-1

And here’s an article about the other new treatment for HER-2 positive breast cancer, Pertuzumab, which just received FDA approval yesterday as a first-line treatment for metastatic breast cancer:

FDA Approves Pertuzumab, Herceptin, and Taxotere combo



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